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Right Care, Right Time?

The industry organisation for the aged care sector, NZACA, has described access to aged care as a “DHB lottery” based on the findings of a research report released in April. The report found older people in some DHBs had to wait six months or more longer for admission to rest home care than others assessed as having the same level of need in other DHBs.

This is despite the evidence of clear improvements in wellbeing and health identified when older people do move into aged residential care. The report has analysed the huge amount of anonymised data collected on over 300,000 needs assessments carried out on older people over the past 3 years. The report found that most older people reported feeling less lonely and less pain after moving into care as well as improved health stability, cognitive performance, independence and mental well-being.

Is Lack of Funding Behind the Variations?

The home support sector providers association HCHA responded to the report by pointing to the variability of access to many health services across DHBs, not just aged care. Their own members regularly report that clients receiving support in their homes need more support than the average of 3 hours a week that DHBs allocate. This compares with the 24 hour care that is available in the rest home setting. The question is whether the variability may be driven more by the debt and funding pressures on DHBs, cutting funding for services to save money.

Choices made by older people themselves must play a central role and it is not easy to find out from the data the extent to which decisions not to go into aged care have been driven by the wishes of the persons themselves. As is pointed out, initial assessments often arise because of illness or injury, so subsequent assessments would most likely show an improvement as the person recovers, regardless of where they live.

Call for More Consistency and Better Funding

There would be wide agreement across both aged care and home support sectors that more consistency to needs assessments and how services are allocated is needed. Similarly both areas would see the level of funding as impacting on services, with the consequences affecting the health and social wellbeing of the thousands of older people.